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https://www.readbyqxmd.com/read/28634720/the-financial-impact-and-drivers-of-hospital-charges-in-contralateral-prophylactic-mastectomy-and-reconstruction-a-nationwide-inpatient-sample-hospital-analysis
#1
Alexandra Bucknor, Anmol Chattha, Klaas Ultee, Winona Wu, Parisa Kamali, Patrick Bletsis, Austin Chen, Bernard T Lee, Claire Cronin, Samuel J Lin
PURPOSE: Rates of contralateral prophylactic mastectomy (CPM) have increased over the last decade; it is important for surgeons and hospital systems to understand the economic drivers of increased costs in these patients. This study aims to identify factors affecting charges in those undergoing CPM and reconstruction. METHODS: Analysis of the Healthcare Cost and Utilization Project National Inpatient Sample was undertaken (2009-2012), identifying women aged ≥18 with unilateral breast cancer undergoing unilateral mastectomy with CPM and immediate breast reconstruction (IBR) (CPM group), in addition to unilateral mastectomy and IBR alone (UM group)...
June 20, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#2
Kumar Dharmarajan, Li Qin, Maggie Bierlein, Jennie E S Choi, Zhenqiu Lin, Nihar R Desai, Erica S Spatz, Harlan M Krumholz, Arjun K Venkatesh
Objective To characterize rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays.Design Retrospective cohort study.Setting 4750 hospitals in the USA.Participants Nationally representative sample of Medicare fee for service beneficiaries aged 65 or over discharged after 363 037 index observation stays, 2 540 000 index emergency department treatment-and-discharge stays, and 2 667 525 index inpatient stays from 2006-11...
June 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28629839/surgery-versus-percutaneous-transcatheter-embolization-for-pulmonary-arteriovenous-malformation-analysis-of-a-national-inpatient-database-in-japan
#3
Masaaki Nagano, Junji Ichinose, Yusuke Sasabuchi, Jun Nakajima, Hideo Yasunaga
OBJECTIVE: Although the treatment options for pulmonary arteriovenous malformation are surgery and percutaneous transcatheter embolization, no study has compared the outcomes between these 2 treatments. METHODS: From the Japanese Diagnosis Procedure Combination database, the medical records of 996 patients who received treatment for pulmonary arteriovenous malformation between 2010 and 2015 were retrospectively reviewed. We created balanced groups for surgery or percutaneous transcatheter embolization using propensity scoring...
May 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28626991/discharge-against-medical-advice-of-elderly-inpatients-in-the-united-states
#4
Carlijn Lelieveld, Rosanne Leipzig, Licia K Gaber-Baylis, Madhu Mazumdar, Stavros G Memtsoudis, Nicole Zubizarreta, Jashvant Poeran
Discharge against medical advice (DAMA) is associated with greater risk of hospital readmission and higher morbidity, mortality, and costs, but with a rapidly increasing elderly inpatient population, there is a lack of national data on DAMA in this subgroup. The National Inpatient Sample (2003-2013 for trends, 2013 for multivariable analysis, n = 29,290,852) was used to describe trends in DAMA in elderly inpatients, to study diagnosis codes associated with admission, and to assess factors associated with DAMA using multivariable logistic regression...
June 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28625367/impact-of-aha-s-2007-guideline-change-on-incidence-of-infective-endocarditis-in-infants-and-children
#5
Rie Sakai Bizmark, Ruey-Kang R Chang, Yusuke Tsugawa, Kenneth M Zangwill, Ichiro Kawachi
Use a nationally representative sample to assess impacts of new clinical guidelines issued by the American Heart Association (AHA) in 2007 for many types of invasive procedures, with recommendations for significant decreases in antimicrobial prophylaxis use. STUDY DESIGN: Interrupted time series analyses of pediatric hospitalizations for Infective Endocarditis (IE), using the Nationwide Inpatient Sample (NIS) ICD-9-CM diagnostic codes, identified IE hospitalizations for patients <18 years old from 2001 to 2012...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28624050/impact-of-hospital-volume-on-outcomes-for-laparoscopic-adhesiolysis-for-small-bowel-obstruction
#6
Raymond A Jean, Kathleen M O'Neill, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Volume-to-outcome data have been studied in several complex surgical procedures, demonstrating improved outcomes at higher volume centers. Laparoscopic lysis of adhesions (LLOA) for small bowel obstruction (SBO) may result in better outcomes, but there is no information on the learning curve for this potentially complex case. This study evaluates the effect of institutional procedural volume on length of stay (LOS), outcomes, and costs in LLOA for SBOs. MATERIALS AND METHODS: The Nationwide Inpatient Sample data set between 2000 and 2013 was queried for discharges for a diagnosis of SBO involving LLOA in adult patients...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28612362/the-economic-burden-of-neonatal-abstinence-syndrome-in-the-united-states
#7
Tammy E Corr, Christopher S Hollenbeak
BACKGROUND AND AIMS: While hospital charges related to neonatal abstinence syndrome (NAS) have increased recently, there are no data available regarding costs. Therefore, we sought to describe the NAS population and compare with the non-NAS population, determine the incidence of NAS in the United States and estimate the total annual costs and hospital days of NAS admissions, and estimate the incremental costs and length of stay of an NAS admission compared with a non-NAS admission. DESIGN: Retrospective, observational study...
June 13, 2017: Addiction
https://www.readbyqxmd.com/read/28611187/comparing-outcomes-of-coronary-artery-bypass-grafting-among-large-teaching-and-urban-hospitals-in-china-and-the-united-states
#8
Zhe Zheng, Heng Zhang, Xin Yuan, Chenfei Rao, Yan Zhao, Yun Wang, Sharon-Lise Normand, Harlan M Krumholz, Shengshou Hu
BACKGROUND: Coronary artery disease is prevalent in China, with concomitant increases in the volume of coronary artery bypass grafting (CABG). The present study aims to compare CABG-related outcomes between China and the United States among large teaching and urban hospitals. METHODS AND RESULTS: Observational analysis of patients aged ≥18 years, discharged from acute-care, large teaching and urban hospitals in China and the United States after hospitalization for an isolated CABG surgery...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28609479/the-impact-of-septicemia-occurring-during-hospitalization-for-renal-transplantation-procedures-on-outcomes-in-adults-in-united-states
#9
Veerajalandhar Allareddy, Sankeerth Rampa, Alexandre T Rotta, Veerasathpurush Allareddy
INTRODUCTION: Immediate success rates of renal transplantation (RT) procedures are generally very high. National estimates of the impact of post-operative complications, specifically, septicemia occurring during hospitalization for RT's on outcomes is unclear. We sought, to examine the prevalence of septicemia in patients having renal transplantation procedures and to quantify the impact of septicemia on in-hospital mortality (IHM), length of stay (LOS), and hospital charges (HC). MATERIALS AND METHODS: We performed a retrospective analysis of the Nationwide Inpatient Sample (NIS) for the years 2004 to 2010...
2017: PloS One
https://www.readbyqxmd.com/read/28608040/paraesophageal-hernia-repair-in-the-usa-trends-of-utilization-stratified-by-surgical-volume-and-consequent-impact-on-perioperative-outcomes
#10
Francisco Schlottmann, Paula D Strassle, Marco E Allaix, Marco G Patti
BACKGROUND: The impact of surgical volume on perioperative results after a paraesophageal hernia (PEH) repair has not yet been analyzed. We sought to characterize the trend of utilization of this procedure stratified by surgical volume in the USA, and analyze its impact on perioperative outcomes. METHODS: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000-2013. Adult patients (≥18 years old) who underwent PEH repair were included...
June 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28603718/impact-of-sleep-apnea-on-in-hospital-outcomes-after-transcatheter-aortic-valve-replacement-insight-from-national-inpatient-sample-database-2011-2014
#11
Ilhwan Yeo, Hasan Ahmad, Wilbert S Aronow
BACKGROUND: Sleep apnea is associated with worse outcomes following various kinds of surgeries. There is a paucity of data on the association of sleep apnea with clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We used National Inpatient Sample (NIS) data 2011-2014 to identify patients undergoing TAVR. Association between sleep apnea and in-hospital postoperative outcomes were assessed by multivariate logistic regression and 1:1 propensity score matching analyses...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28602536/national-incidence-of-reportable-quality-metrics-in-the-knee-arthroplasty-population
#12
Joseph E Tanenbaum, Derrick M Knapik, Steven J Fitzgerald, Randall E Marcus
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) characterizes adverse quality events in the inpatient setting as patient safety indicators (PSI). The incidence of PSI has not been quantified in the total knee arthroplasty (TKA) population. METHODS: All patients in the Nationwide Inpatient Sample who underwent primary TKA during an inpatient episode in 2013 were identified using International Classification of Disease, Ninth Revision, Clinical Modification codes...
May 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28601311/the-prevalence-of-psychiatric-diagnoses-and-associated-mortality-in-hospitalized-us-trauma-patients
#13
Laura L Townsend, Micaela M Esquivel, Tarsicio Uribe-Leitz, Thomas G Weiser, Paul M Maggio, David A Spain, Lakshika Tennakoon, Kristan Staudenmayer
BACKGROUND: We hypothesized that psychiatric diagnoses would be common in hospitalized trauma patients in the United States and when present, would be associated with worse outcomes. MATERIALS AND METHODS: The Nationwide Inpatient Sample (NIS, 2012) was used to determine national estimates for the number of patients admitted with an injury. Psychiatric diagnoses were identified using diagnosis codes according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601194/relation-between-obesity-and-survival-in-patients-hospitalized-for-pulmonary-arterial-hypertension-from-a-nationwide-inpatient-sample-database-2003-to-2011
#14
Manyoo Agarwal, Sahil Agrawal, Lohit Garg, Carl J Lavie
There have been numerous studies reporting lower mortality rates in obese patients with various cardiovascular disorders than in nonobese patients, a phenomenon known as the "obesity paradox." Limited data exist regarding the effect of obesity on prognosis in patients with pulmonary arterial hypertension (PAH). We used the National Inpatient Sample database for years 2003 to 2011 to identify all patient hospitalizations aged ≥18 years with a primary diagnosis of PAH. Patients with a diagnosis of obesity were identified using Elixhauser co-morbidity measure provided in Nationwide Inpatient Sample database, based on International Classification of Diseases, Ninth Revision, Clinical Modification, codes and the diagnosis-related groups...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28595885/the-effect-of-clinical-care-location-on%C3%A2-clinical-outcomes-after-peripheral%C3%A2-vascular-intervention-in-medicare-beneficiaries
#15
Ryan S Turley, Xiaojuan Mi, Laura G Qualls, Sreekanth Vemulapalli, Eric D Peterson, Manesh R Patel, Lesley H Curtis, W Schuyler Jones
OBJECTIVES: Modifications in reimbursement rates by Medicare in 2008 have led to peripheral vascular interventions (PVI) being performed more commonly in outpatient and office-based clinics. The objective of this study was to determine the effects of this shift in clinical care setting on clinical outcomes after PVI. BACKGROUND: Modifications in reimbursement have led to peripheral vascular intervention (PVI) being more commonly performed in outpatient hospital settings and office-based clinics...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28595583/the-association-between-number-of-doctors-per-bed-and-readmission-of-elderly-patients-with-pneumonia-in-south-korea
#16
Joo Eun Lee, Tae Hyun Kim, Kyoung Hee Cho, Kyu-Tae Han, Eun-Cheol Park
BACKGROUND: There is an urgent need to reduce readmission of patients with pneumonia and improve quality of care. To assess the association between hospital resources and quality of care, we examined the effect of number of doctors per bed on 30-day readmission and investigated the combined effect of number of doctors per bed and number of beds. METHODS: We used nationwide cohort sample data of health insurance claims by the National Health Insurance Service (NHIS) from 2002 to 2013...
June 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28593266/wireless-monitoring-program-of-patient-centered-outcomes-and-recovery-before-and-after-major-abdominal-cancer-surgery
#17
Virginia Sun, Sinziana Dumitra, Nora Ruel, Byrne Lee, Laleh Melstrom, Kurt Melstrom, Yanghee Woo, Stephen Sentovich, Gagandeep Singh, Yuman Fong
Importance: A combined subjective and objective wireless monitoring program of patient-centered outcomes can be carried out in patients before and after major abdominal cancer surgery. Objective: To conduct a proof-of-concept pilot study of a wireless, patient-centered outcomes monitoring program before and after major abdominal cancer surgery. Design, Setting, and Participants: In this proof-of-concept pilot study, patients wore wristband pedometers and completed online patient-reported outcome surveys (symptoms and quality of life) 3 to 7 days before surgery, during hospitalization, and up to 2 weeks after discharge...
June 7, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28586894/association-between-cirrhosis-and-stroke-in-a-nationally-representative-cohort
#18
Neal S Parikh, Babak B Navi, Yecheskel Schneider, Arun Jesudian, Hooman Kamel
Importance: Cirrhosis is associated with hemorrhagic and thrombotic extrahepatic complications. The risk of cerebrovascular complications is less well understood. Objective: To investigate the association between cirrhosis and various stroke types. Design, Setting, and Participants: We performed a retrospective cohort study using inpatient and outpatient Medicare claims data from January 1, 2008, through December 31, 2014, for a random 5% sample of 1 618 059 Medicare beneficiaries older than 66 years...
June 5, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28583812/cost-of-bariatric-surgery-and-factors-associated-with-increased-cost-an-analysis-of-national-inpatient-sample
#19
Zhamak Khorgami, Ali Aminian, Saeed Shoar, Amin Andalib, Alan A Saber, Philip R Schauer, Stacy A Brethauer, Guido M Sclabas
BACKGROUND: In the current healthcare environment, bariatric surgery centers need to be cost-effective while maintaining quality. OBJECTIVE: The aim of this study was to evaluate national cost of bariatric surgery to identify the factors associated with a higher cost. SETTING: A retrospective analysis of 2012-2013 Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS). METHOD: We included all patients with a diagnosis of morbid obesity (ICD9 278...
April 15, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28583465/functional-status-is-associated-with-30-day-potentially-preventable-hospital-readmissions-following-inpatient-rehabilitation-among-aged-medicare-fee-for-service-beneficiaries
#20
Addie Middleton, James E Graham, Kenneth J Ottenbacher
OBJECTIVE: To determine the association between patients' functional status at discharge from inpatient rehabilitation and 30-day potentially preventable hospital readmissions. A secondary objective was to examine the conditions resulting in these potentially preventable readmissions. DESIGN: Retrospective cohort study. SETTING: Inpatient rehabilitation facilities submitting claims to Medicare. PARTICIPANTS: National cohort of 371,846 inpatient rehabilitation discharges among aged Medicare fee-for-service beneficiaries in 2013-2014...
June 2, 2017: Archives of Physical Medicine and Rehabilitation
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